-This book is required reading at Yale Medical School-
Fox, Margalit (2012)
Fox, Margalit (2012)
Anne Fadiman's (1997) book The Spirit Catches You and You Fall Down: a Hmong Child, her American Doctors, and the Collision of Two Cultures is a poignant read that recounts the tragic consequences of cultural incompetence within the context of healthcare.
A Hmong couple, Nao Kao and Foua Lee, and their children emigrated from a Laos refugee camp to Merced, CA in 1980. In 1982 the Lee’s gave birth to a daughter Lia, who at 3 months old suffered her first seizure. On several occasions the Lee’s took Lia to Merced Community Medical Center (MCMC) when the seizures were especially bad. Unfortunately by the time Lia arrived at the hospital the seizures had stopped. The Lee’s, with no understanding of the English language or written word and no translator available, were unable to communicate Lia’s symptoms to the emergency room physicians. Lia was diagnosed with bronchopneumonia and sent home on antibiotics, of which the Lee’s could not even read the label. It was 5 months later when the ER doctors witnessed Lia’s seizure and she was diagnosed with epilepsy. The Lee’s called this qaug dab peg (which means the spirit catches you and you fall down). To them it was a spiritual illness; they thought their daughter's soul was wandering and needed to be called back from the farthest reaches of the spirit world. Lia was prescribed multiple types of anti-seizure medications, yet the seizures continued. Lia's parents thought the medicines were making their daughter worse and sought other treatments. Her doctors grew frustrated as the family called in shamans, sacrificed roosters, tied strings around her wrist and did not always give their daughter her prescriptions. A wide rift grew between the Lee’s understanding of Lia’s epilepsy and the doctors who practiced biomedicine. At the age of 3, Lia was removed from her home by Child Protective Services and placed in foster care, the seizures and hospitalizations continued. A year later, with the help of Social Services, Lia was returned home. The Lee’s had agreed to administer all medications as ordered. At the age of 4, Lia suffered a grand mal seizure and was hospitalized. She had lost all higher brain function and was sent home to die (Fadiman 1997). Her family lovingly cared for her in their home until her death on August 31, 2012; age 30 years and 1 month. |
Photo retrieved from http://www.nytimes.com/imagepages/2012/09/15/us/LEPE-obit.html
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-The video below will give the viewer an understanding of what it may have been like for the Lee's when they entered MCMC-
Video retrieved from http://www.youtube.com/watch?v=coCsSev55Y4